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Patient Information

Patient Forms
Our office is technology savvy and totally paperless. For your convenience, all patient forms should be completed securely online PRIOR , to your first appointment within our office.
When filling out the New patient forms, there are 5 forms to be completed, Please fill out one at a time, and submit them one at a time. Some forms have multiple pages.

Payment Options
For your convenience, we accept cash, checks, Visa, MasterCard, Discover, American Express and CareCredit® (3mo, 6mo & 12mo No Interest). Ourtreatment coordinator is always available to help you with your dental plan and can assist you as you decide on payment options prior to beginning your dental treatment. Full payment is due at time services are rendered, unless prior financial arrangements have been made.

If you have dental insurance, we will be happy to help you determine the coverage you have available. Your insurance coverage however is a contract between you, your employer and the insurance company. Our office accepts all major insurance plans. We are an in-network provider forAetna, Ameritas, Assurant, CIGNA, Delta Dental, Guardian, Humana, MetLife, Principal Financial Group, Sun Life Financial, and United Concordia..

As a courtesy, our staff will promptly and efficiently process insurance claims. We will collect ONLY your patient portion at time of treatment. We will do all that we can to ensure your benefits are being used in the best way possible. We cannot guarantee payment of your claims, or accept the responsibility of negotiating claims with insurance companies or other persons. If your insurance company pays only a portion of your treatment or rejects your claim you are responsible for full payment of services rendered. Claims not paid within 60 days of date of service become the responsibility of the patient or guardian.

After receipt of insurance benefits an itemized statement covering all services rendered will be mailed reflecting the amount currently due, if any. A copy of your insurance company’s Explanation of Benefits (EOB) will be included to explain your balance due.

If your insurance has changed, please call us prior to your appointment and bring your new insurance card with you.

Cancellation Policy
Scheduled appointments are for the benefit of both the patient and the doctor and are RESERVED EXCLUSIVELY for you. It allows patients to be seen quickly and efficiently, to maintain an effective flow of the doctor’s schedule, and also allows the doctor to spend quality time with each patient.

  • We must be notified 24 hours in advance of any schedule change to your appointment. 
  • Tardiness of more than 10 minutes may constitute loss of an appointment.
  • Failure to notify our office 24 hours in advance of a schedule change or No Showing for an appointment will result in a cancellation charge of $50.00.

What to do in an Emergency

Use our After-Hours telephone number (214) 681-7800  if you need to reach us after 5pm (Monday – Thursday) or on the weekends.

If you need to contact us about a dental emergency, please call us for faster results.Use our After-Hours number if you need to reach us after 5pm (Monday – Thursday) or on the weekends. A team member will respond to any email messages as soon as possible. Or click here to set up an appointment now.

  • Typical Tooth Problems
    Did you lose a filling? Did your crown or cap come off? Does your tooth hurt?

  • Soft-Tissue Problems
    Bleeding gums, swollen or tender